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Ophthalmology > Sudden Visual Loss > Flashcards

Sudden Visual Loss Flashcards

1
Q

list some conditions that cause sudden visual loss

A 
central retinal artery occlusion 
central retinal vein occlusion 
retinal detachment 
vitreous haemorrhage 
optic neuritis
wet ARMD
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2
Q

list some risk factors for developing CRAO

A 
diabetes
atherosclerosis 
hyperlipidaemia 
giant cell arteritis 
emboli from carotid artery disease
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3
Q

are CRAO and CRVO painful or painless losses of vision

A

painless

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4
Q

what are the examination findings (fundoscopy) of CRAO

A

RAPD
cherry red spot on macula
pale oedematous retina with thread like vessels

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5
Q

how is CRAO treated

A

if present within 24 hours try to convert to branch occlusion by giving IV acetazolamide and ocular massage

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6
Q

how does branch occlusion differ from central occlusion

A

branch is a less severe form, visual loss is less profound

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7
Q

which is more common, CRAO or CRVO

A

CRVO

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8
Q

list some risk factors for developing CRVO

A 
age
hyperviscosity 
raised IOP
diabetes/sarcoidosis 
hypertension
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9
Q

what are the examination findings of CRVO

A

swollen optic disc
dilated tortuous vessels
retinal flame haemorrhages
cotton wool spots +/- neovascularisation

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10
Q

what is amaurosis fugax

A

transient blockage of central retinal artery

think of as TIA is the eye

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11
Q

what is the clinical presentation of amaurosis fugax (buzzword)

A

sudden painless vision loss

curtain coming down over the eye lasting less than 5 mins

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12
Q

how is CRVO treated

A

allow time to heal

intravitreal anti VEGF injection

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13
Q

optic neuropathy is sub-divided into which 2 types

A

arteritic and non-arteritic

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14
Q

what causes arteritic optic neuropathy

A

giant cell arteritis - presents with sudden vision loss with headache, jaw claudication and scalp tenderness

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15
Q

how is arteritis optic neuropathy managed

A

high dose prednisolone, vision loss is permanent but prevention is key

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16
Q

what is the typical patient presenting with non-arteritis optic neuropathy

A

a hypermetrope aged 45-60 who smokes, presentation same as arteritic

17
Q

what is a vitreous haemorrhage

A

bleed that arises from retinal neovascularisation

18
Q

list the causes of vitreous haemorrhage

A

diabetes
CRVO/BRVO
retinal tears
retinal detachment

19
Q

what are the examination findings of vitreous haemorrhage

A

loss of red reflex
no RAPD
sudden vision loss

20
Q

how is vitreous haemorrhage treated

A

usually spontaneously resolves

21
Q

what are the risk factors for retinal detachment

A

myopia (short sightedness) as eyes are bigger
retinal tar
trauma
secondary to diabetes

22
Q

what is the presentation of retinal detachment

A

curtain coming down over eyes lasting >5 minutes
flashes and floaters
RAPD
detached wrinkly retina

23
Q

how is retinal detachment managed

A

surgery
laser
prognosis usually good

24
Q

what conditions cause optic neuritis

A

multiple sclerosis

ethanbutol use and syphilis less common

25
Q

optic neuritis is painless/painful and unilateral/bilateral visual loss

A

painful

unilateral

26
Q

outline the features of optic neuritis

A

central scotoma
reduces colour vision
on examination RAPD, enlarged blind spot

27
Q

what is a central scotoma

A

loss of central field of vision

28
Q

how is optic neuritis managed

A

investigate for MS

IV prednisolone to speed up recovery but acuity is not improved

29
Q

what causes aged related macular degeneration to arise

A

pigment and drusen are produced at the macula leading to retinal atrophy and central retinal detachment

30
Q

list the risk factors for developing ARMD

A

increasing age
smoking
cardiovascular risk factors
cataract surgery

31
Q

what are the 2 types of ARMD

A

wet and dry

32
Q

how to wet and dry ARMD differ

A

wet - sudden visual loss, arises when choroidal neovascular membranes develop under the retina which leak fluid
dry - general wear and tear of the macula, gradual vision loss

33
Q

describe the presentation of wet ARMD

A

on examination fluid exudation and detachment of pigment

metamorphopsia - distorsion of central vision

34
Q

how is wet ARMD managed

A

stop smoking

anti VEGF intravitral injection

Ophthalmology (11 decks)

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